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Junlén HR, Lockmer S, Kimby E, Wahlin BE. Absolute B cell counts in blood predict long-term response in follicular lymphoma patients treated with rituximab without chemotherapy. Ann Hematol 2020; 99:2357-2366. [PMID: 32808106 PMCID: PMC7481163 DOI: 10.1007/s00277-020-04208-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 02/07/2023]
Abstract
Rituximab monotherapy is widely used for follicular lymphoma. However, there are no established predictors for response or response duration. We analyzed the long-term prognostic relevance of pre-treatment absolute blood counts of lymphocytes with subsets and monocytes in 265 follicular lymphoma patients, uniformly treated with rituximab without chemotherapy, in two Nordic Lymphoma Group trials. There were 265 previously untreated, stage II–IV follicular lymphoma patients with a median follow-up of over 10 years. Absolute B cell counts ≥ median (0.09 × 109/L) were an independent predictor for shorter time to next treatment or death (multivariable analysis P = 0.010). In univariate analysis, absolute monocyte counts ≥ median (0.5 × 109/L) did not correlate with time to next treatment or death, but with inferior overall survival (P = 0.034). Absolute T cell or T cell subset counts were not predictive for outcome. High absolute B cell counts, possibly reflecting circulating lymphoma cells, have an unfavorable impact on time to next treatment or death in patients treated with rituximab without chemotherapy.
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Affiliation(s)
- Henna-Riikka Junlén
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Sandra Lockmer
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden.,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Kimby
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden
| | - Björn Engelbrekt Wahlin
- Unit of Hematology, Department of Medicine, Karolinska Institutet, Huddinge, Stockholm, Sweden. .,Medicinsk enhet Hematologi, Tema Cancer, Karolinska University Hospital, Stockholm, Sweden.
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de Pádua Covas Lage LA, Hamasaki DT, Moreira FR, Rocha V, Zerbini MCN, Pereira J. Absolute monocyte count is a predictor of overall survival and progression-free survival in nodal peripheral T cell lymphoma. Ann Hematol 2019; 98:2097-2102. [PMID: 31243570 DOI: 10.1007/s00277-019-03731-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/10/2019] [Indexed: 11/25/2022]
Abstract
Nodal peripheral T cell lymphomas (nPTCL) present aggressive clinical course, and its heterogeneous nature and poor prognosis with current therapeutic strategies make it a target for the development of new prognostic markers. Thus, we investigated tumor-associated macrophages (TAM) according to the number of cells expressing CD68 in biopsies and the absolute monocyte count (AMC) in peripheral blood of 87 patients with nPTCL. The median overall survival (OS) was 3 years (95% CI 1.3-8.4 years) and estimate 5 years OS of 43.3% (95% CI 32.5-53.7%). The median progression-free survival (PFS) was 1.5 years (95% CI 0.8-2.6 years) with estimate 5 years PFS of 29.2% (95% CI 19.7-39.3%). The cutoff for AMC was 1.5 × 109/L and the median OS for patients with AMC ≥ 1.5 × 109/L was 0.83 years versus 3.7 years for those with AMC < 1.5 × 109/L (HR 2.32, 95% CI 1.03-5.22, p = 0.035). The median PFS for patients with AMC ≥ 1.5 × 109/L was 0.50 years versus 1.5 years for those with AMC < 1.5 × 109/L (HR 2.25, 95% CI 1.05-4.78, p = 0.031). CD68 was evaluated in 26/87 (29.8%) patients with a median expression of 34% and positivity cutoff of 43%. CD68 expression was not associated with OS or PFS either with AMC values. Our findings suggest that the AMC of ≥ 1.5 × 109/L at diagnosis in peripheral blood is associated with poor prognosis in nPTCL. Further investigations in a larger cohort are required to better validate our results.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, CD/blood
- Antigens, Differentiation, Myelomonocytic/blood
- Disease-Free Survival
- Female
- Humans
- Leukocyte Count
- Lymphoma, T-Cell, Peripheral/blood
- Lymphoma, T-Cell, Peripheral/drug therapy
- Lymphoma, T-Cell, Peripheral/mortality
- Lymphoma, T-Cell, Peripheral/pathology
- Male
- Middle Aged
- Monocytes/metabolism
- Monocytes/pathology
- Neoplasm Proteins/blood
- Retrospective Studies
- Survival Rate
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Affiliation(s)
- Luís Alberto de Pádua Covas Lage
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Débora Toshie Hamasaki
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Frederico Rafael Moreira
- Statistical of Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
| | - Vanderson Rocha
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
- Fundação Pró-Sangue, São Paulo, SP, Brazil
- Churchill Hospital, Oxford University, Oxford, UK
| | | | - Juliana Pereira
- Department of Hematology, Hemotherapy and Cell Therapy, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil
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Jia T, Zhu HY, Wang L, Liang JH, Cao L, Xia Y, Wu JZ, Wu W, Fan L, Li JY, Xu W. [The prognostic significance of peripheral lymphocyte/monocyte ratio and PET-2 evaluation in adult Hodgkin's lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:372-377. [PMID: 31207700 PMCID: PMC7342242 DOI: 10.3760/cma.j.issn.0253-2727.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Indexed: 11/24/2022]
Abstract
Objective: To evaluate the prognostic value of lymphocyte to monocyte ratio (LMR) and PET scan performed after first two cycles of chemotherapy (PET-2) in Hodgkin's lymphoma (HL) . Methods: The clinical data of 133 patients with HL diagnosed from January 2007 to March 2016 at the First Affiliated Hospital of Nanjing Medical University, were retrospectively analyzed. The X-tile software was used to calculate the optimal cut-off value of LMR. Kaplan-Meier method and Cox regression were used for survival analysis. Results: The median age of 133 HL patients was 33 (18-84) years, and the male to female ratio was 1.9∶1. The optimal cut-off value of LMR was 2.5, and progression free survival (PFS) (P<0.001) and overall survival (OS) (P<0.001) were significantly lower in the LMR<2.5 group than that of LMR≥2.5. Multivariate survival analysis showed that LMR<2.5 was an independent predictor of PFS (P=0.002, HR=2.35, 95%CI 1.36-4.07) and OS (P=0.002, HR=10.36, 95%CI 2.35-45.66) in HL patients. The analysis of PET-2 from 56 HL patients showed that PET-2 positive patients had significantly poorer PFS (P=0.022) . After grouping LMR combined with PET-2, significant differences were found in PFS and OS between the three groups (P values were 0.009 and 0.012) . Conclusion: LMR<2.5 is an independent prognostic factor for patients with HL. PET-2 combined with LMR may have better prognostic value.
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Affiliation(s)
- T Jia
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China; Department of Hematology, the First People's Hospital of Lianyungang, Lianyungang 222002, China
| | - H Y Zhu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - L Wang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J H Liang
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - L Cao
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - Y Xia
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Z Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - W Wu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - L Fan
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - J Y Li
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
| | - W Xu
- Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China
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B2 microglobulin is a novel prognostic marker of Angioimmunoblastic T-cell lymphoma. Sci Rep 2018; 8:12907. [PMID: 30150635 PMCID: PMC6110724 DOI: 10.1038/s41598-018-31212-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/08/2018] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to analyze features and explore parameters that can help to predict prognosis for angioimmunoblastic T-cell lymphoma (AITL). A total of 117 patients with AITL were retrospectively analyzed. Multivariate analysis showed that β2 microglobulin (β2-M) ≥4.0 mg/L (P = 0.020), rash/pruritus (P = 0.004), performance status (PS) ≥2 (P = 0.006), age >60 years (P = 0.006) and extranodal sites (ENSs) >1 (P = 0.029) were independent risk factors for OS. Rash/pruritus (P = 0.007), age >60 years (P = 0.035) and ENSs >1 (P = 0.006) were independent risk factors for PFS. A novel prognostic model consisting of β2-M, rash/pruritus, PS, age and ENSs >1 was constructed. The model classified patients into 3 risk stratifications: low risk (0 or 1 factor), intermediate risk (2 factors), high risk (≥3 factors) and significantly stratified patients with AITL (P < 0.001). In conclusion, except for PS ≥2, age >60 years and ENSs >1 used in IPI, β2-M and rash/pruritus also indicated adverse prognosis. That we constructed model was commendably prognostic for OS and PFS.
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Jia T, Zhang R, Zhu HY, Liang JH, Wang L, Wu W, Cao L, Li JY, Xu W. Prognostic significance of peripheral blood absolute monocyte count and lymphocyte to monocyte ratio in anaplastic large cell lymphoma. Cancer Biomark 2018; 22:807-813. [PMID: 29945349 DOI: 10.3233/cbm-181505] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Tao Jia
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
- Department of Hematology, The First People’s Hospital of Lianyungang City, Lianyungang 222002, Jiangsu, China
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
| | - Run Zhang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
| | - Hua-Yuan Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Jin-Hua Liang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Li Wang
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Wei Wu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Lei Cao
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Jian-Yong Li
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
| | - Wei Xu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, Jiangsu, China
- Key Laboratory of Hematology of Nanjing Medical University, Nanjing 210029, Jiangsu, China
- Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing 210029, Jiangsu, China
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Santegoets SJAM, Welters MJP, van der Burg SH. Monitoring of the Immune Dysfunction in Cancer Patients. Vaccines (Basel) 2016; 4:vaccines4030029. [PMID: 27598210 PMCID: PMC5041023 DOI: 10.3390/vaccines4030029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/25/2016] [Accepted: 08/27/2016] [Indexed: 12/16/2022] Open
Abstract
Immunotherapy shows promising clinical results in patients with different types of cancer, but its full potential is not reached due to immune dysfunction as a result of several suppressive mechanisms that play a role in cancer development and progression. Monitoring of immune dysfunction is a prerequisite for the development of strategies aiming to alleviate cancer-induced immune suppression. At this point, the level at which immune dysfunction occurs has to be established, the underlying mechanism(s) need to be known, as well as the techniques to assess this. While it is relatively easy to measure general signs of immune suppression, it turns out that accurate monitoring of the frequency and function of immune-suppressive cells is still difficult. A lack of truly specific markers, the phenotypic complexity among suppressive cells of the same lineage, but potentially with different functions and functional assays that may not cover every mechanistic aspect of immune suppression are among the reasons complicating proper assessments. Technical innovations in flow and mass cytometry will allow for more complete sets of markers to precisely determine phenotype and associated function. There is, however, a clear need for functional assays that recapitulate more of the mechanisms employed to suppress the immune system.
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Affiliation(s)
- Saskia J A M Santegoets
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Marij J P Welters
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
| | - Sjoerd H van der Burg
- Department of Medical Oncology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
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